Hydrocortisone in the management of acute hypoadrenocorticism in dogs: a retrospective series of 30 cases.

OBJECTIVES: The objectives of this study were to describe the efficacy, outcome and adverse effects of intravenous hydrocortisone and fluid therapy for the management of acute hypoadrenocorticism in dogs.

METHODS: A retrospective review of dogs with primary hypoadrenocorticism receiving intravenous hydrocortisone and fluid therapy was performed.

RESULTS: Thirty newly-diagnosed dogs were included. There was an excellent clinical response, with all dogs surviving to discharge within a median of 2 days. In 23 cases with complete data, the mean rate of change of sodium over 24 hours was 0·48 (±0·28) mmol/L/hour, while the mean rate of change of potassium was -0·12 (±0·06) mmol/L/hour. Circulating potassium concentration normalised in 68·4% and 100% of cases of by 12 and 24 hours, respectively. Additional treatment for hyperkalaemia was not found necessary. Plasma sodium concentration increased by >12 mmol/L/24 hours on 7 of 23 (30·4%) occasions. One dog exhibited associated temporary neurological signs.

CLINICAL SIGNIFICANCE: Intravenous hydrocortisone infusion and fluid therapy for the management of acute hypoadrenocorticism is associated with a rapid resolution of hyperkalaemia and is well tolerated with few adverse effects. Regular electrolyte monitoring is required to ensure that rapid increases in sodium concentration are avoided.